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Nursing Care Plan Death Anxiety

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Nursing Care Plan Death Anxiety Definition:Vague uneasy feeling of discomfort or dread generated by perceptions of a real or imagined threat to one’s existence,Nursin Care Plan

Defining Characteristics

  • Worry about the impact of one’s death on significant others
  • Powerlessness over issues related to dying
  • Fear of loss of physical and mental abilities when dying
  • Total loss of control over aspects of one’s own death
  • Worry about being the cause of others’ suffering or grief
  • Fear of leaving family alone after death
  • Fear of developing a terminal illness

Related Factors

  • Death Anxiety
  • Anticipating the impact of death on other
  • Anticipating suffering
  • Experiencing the dying process
  • Uncertainty about life after death
  • Uncertainty about the existence of a higher power

Assessment Focus

  • Behavior
  • Communication
  • Emotional status

Expected Outcomes

The Patient Will

  • Identify time alone and time needed with others.
  •  Communicate important thoughts and feelings to family members.
  • Obtain the level of spiritual support desired.
  • Use available support systems.
  • Perform self-care activities to tolerance level.
  • Express feelings of comfort and peacefulness.

Suggested Noc Outcomes

Acceptance: Health Status; Anxiety Level; Depression Level; Dignified Life Closure; Fear Self-Control; Hope

Interventions And Rationales

Determine: Assess how much support the patient desires. Patients may want a higher degree of independence in dealing with death than the caregiver wants to allow.Assess patient’s spiritual needs. Often as death approaches, individuals begin thinking more about the needs of the spirit.Determine which comfort measures the family believes will enhance feelings of well-being. Dying patients have the right to decide how much physical, emotional, and spiritual care they wish to have.Perform: Administer medication to relieve pain and provide comfort as required. Medicating at an appropriate level does much to relieve pain and often helps the dying person maintain greater feeling of self-control.Turn and reposition patient at least every 2 hr. Turning and repositioning prevent skin breakdown, improve lung expansion, and prevent atelectasis. Establish a turning schedule for the dependent patient. Post schedule at bedside and monitor frequency.Provide simple physical gestures of support such as holding hands with the patient and encouraging family members to do the same. Patient may want to experience less touching when he or she begins to let go.Provide comfort measures including bath, massage, regulation of environmental temperature, and mouth care according to patient’s preferences. These measures promote relaxation and feelings of well being.Inform: Teach family members ways of discerning unobtrusively what the patient’s desires for comfort and peace are at this time because some patients prefer not to be bothered unless they specifically request comfort measures. Being sensitive to patient needs promotes individualized care.Teach caregivers to assist patient with self-care activities in a way that maximizes patient’s rights to choose. This enables caregivers to participate in patient’s care while supporting patient’s independence.Attend: Help family identify, discuss, and resolve issues related to patient’s dying. Provide emotional support and encouragement to help. Clear communication promotes family integrity.Demonstrate to patient willingness to discuss the spiritual aspects of death and dying to foster an open discussion. Keep conversation focused on patient’s spiritual values and the role they play coping with dying. Meeting the patient’s spiritual needs conveys respect for the importance of all aspects of care.If patient is confused, provide reassurance by telling him or her who is in the room. This information may help to reduce anxiety.Manage: Refer to hospice for end-of-life care if this has not already been done. Communicate to the hospice nurse where the patient is at present in coping with the terminal illness. Continuity of care is crucial during times of stress.Refer to a member of the clergy or a spiritual counselor, according to the patient’s preference, to show respect for the patient’s beliefs and provide spiritual care.

Suggested Nic Interventions

Active Listening; Anticipatory Guidance; Family Involvement Promotion;Pain Management; Spiritual Support; Touch

Reference

Duggleby, W., & Berry, P. (2005, August). Transitions and shifting goals of care for palliative patients and their families. Clinical Journal of Oncology Nursing, 9(4), 425–448.